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Pregnancy Rates Rise Among Women Living With HIV

VANCOUVER, B.C. (August 21, 2017) New research from the Canadian HIV Women’s Sexual and Reproductive Health cohort study (CHIWOS), supported by the BC Centre for Excellence in HIV/AIDS finds that HIV treatment and supportive care is enabling safer reproductive options for women living with HIV, with nearly 25% of women reporting a pregnancy after an HIV diagnosis.

These trends are due in part, to better health and survival of women living with HIV who have access to HIV treatment and care, their changing desires for motherhood and the opportunities for safe pregnancy afforded by combination anti-retroviral therapy (cART). Women living with HIV who are on cART, and have a sustained undetectable HIV viral load, have a very low risk of transmitting HIV to sexual partners during condomless sex or to infants during pregnancy, delivery, or breastfeeding.

"In British Columbia, among pregnant women living with HIV engaged in care and successfully on treatment, we have not had a single HIV transmission from a mother to child in over 20 years. This is an enormous success story for women, children, and families in our province." says Professor Deborah Money, a study co-author and lead for maternity care at the Oak Tree Clinic, the provincial referral centre for women living with HIV and their families at BC Women’s Hospital.

However, the study also found that 61% of pregnancies among women living with HIV were reported as unplanned (rather than planned), which is higher than rates in the general Canadian population. Women who reported unplanned pregnancies were more likely to be young, single, and born in Canada. In the study, unplanned pregnancies were associated with higher rates of pregnancy termination and poorer maternal health outcomes.

"The power to decide if, when and how to become pregnant is central to sexual and reproductive health and rights," says researcher Kate Salters, based at the BC Centre for Excellence in HIV/AIDS. "Our study highlights the on-going importance of women-centred HIV care, including integrated HIV and reproductive support to address gaps in sexual and reproductive health care for women and improve women’s overall health."

The study included over 1400 women living with HIV across Canada and observed pregnancy was more frequent in the modern HIV treatment era, compared with earlier years of the HIV epidemic. Women receiving combination antiretroviral therapy (cART) were nearly three times more likely to become pregnant compared with women who were not receiving cART.

"These findings, showing that women living with HIV can and do become happily pregnant and have healthy babies, are important for women, many of whom worry that having HIV precludes them from motherhood," says Dr. Angela Kaida, Associate Professor and Canada Research Chair, Faculty of Health Sciences at Simon Fraser University. "While an unplanned pregnancy does not necessarily mean an unwanted pregnancy, the findings signal potential gaps in comprehensive family planning support for women living with HIV in Canada."

CHIWOS (Canadian HIV Women’s Sexual and Reproductive Health) is an on-going community-based study with over 1400 women living with HIV enrolled from British Columbia, Ontario, and Quebec. For more information about CHIWOS, please visit www.chiwos.ca.